New graduate RN internship program: a collaborative approach for system-wide integration.

Population growth and aging increase the demand for skilled nurses. Hospitals face the challenge of supplying experienced and qualified caregivers. The cost of training new nurses remains significant. Nursing educators are pivotal in developing the nursing workforce, especially under tightening constraints. This article examines the development of a nursing internship program aimed at attracting and retaining newly graduated nurses and its effect on retention to the institution.

Anatomy of a code. How do you feel at the start of a code blue?

Prepare for a code by recognizing breathing and circulation signs before trouble occurs. Know when to call a code, and how to move past your adrenaline rush to act effectively.

[A case of high-flow priapism successfully treated with percutaneous selective embolization of the internal pudendal artery]. / Prípad vysokoprutokového priapismu úspesne vyreseného perkutánní selektivní embolizací a. pudendalis interna.

Relatively rare high-flow priapism is most frequently caused by contusion or direct injury of the cavernous artery with a subsequent uncontrolled inflow of arterial blood into the cavernous bodies. Knowledge of this pathophysiology and the development of intervention radiology made a more selective therapeutic approach possible. The authors present a report on a case of arterial or high-flow priapism which was successfully resolved by a minimally invasive approach--percutaneous superselective transcatheter embolization of the internal pudendal artery.

Effectiveness of SWL for lower-pole caliceal nephrolithiasis: evaluation of 452 cases.

The authors report on the treatment of lower-pole caliceal nephrolithiasis with extracorporeal shockwave lithotripsy (SWL) using the Czech-made Medilit M-5 lithotripter. In 310 patients, they have performed 452 treatments and evaluated the results 3 months after the last session using plain radiographs and ultrasound examination. The effectiveness of treatment and the success rate of SWL decreased with increasing size of stones: with stones >20 mm, it declined to 30%. This poor success rate was attributable not only to the size of the concrement, but also to its location in a lower calix, which is unfavorable for the passage of fragments. For big lower-pole caliceal stones (>20 mm in the longest diameter), the authors recommend percutaneous nephrolithotomy as the primary management method, the effectiveness of which does not depend on the size of the stone. The success rate achieved in treating the lower-pole caliceal lithiasis using the Medilit M-5 machine was 61.3%, similar to that achieved with other lithotripters.

[Pitfalls in intravesical immunotherapy of superficial carcinoma of the gallbladder with BCG vaccine]. / Uskalí intravezikální imunoterapie povrchového karcinomu mocového mechýre BCG vakcínou.

The authors present their experience with the use of BCG immunotherapy in the treatment of superficial carcinoma of the urinary bladder in 30 patients as regards side-effects and tolerance of preparations. In the discussion they deal in particular with the classification and therapy of side-effects.

[Intravesical immunotherapy with BCG vaccine in superficial carcinoma of the urinary bladder]. / Intravezikální imunoterapie povrchového karcinomu mocového mechýre BCG vakcínou.

The authors present their experience with the use of BCG immunotherapy in the treatment of superficial bladder cancer in 42 patients as regards antitumorous effectivity. They compare BCG immunotherapy with intravesical chemotherapy and evaluate exact diagnostics before indication BCG immunotherapy.

[Initial experience with the MESA and TESE techniques in the treatment of infertile men with azoospermia]. / První zkusenosti s technikami MESA a TESE pri lécbe infertilních muzu s azoospermií.

The authors evaluate their initial experience and results of the technique of microsurgical aspiration of epididymal sperm (MESA) and extraction of testicular sperm (TESE) combined with intracytoplasmic sperm injection into the oocyte (ICSI) in men with azoospermia. The above methods were used in 16 patients with repeatedly assessed azoospermia. Epididymal sperm was obtained in six instances, testicular sperm in 10 instances. With epididymal sperm after ICSI 50% fertilization was achieved after ICSI, with testicular sperm 51% fertilization of oocytes.

[Effective treatment of nephrolithiasis of the lower calix using ESWL (evaluation of 452 procedures)]. / Efektivnost resení nefrolitiázy dolního kalichu metodou ESWL (zhodnocení 452 výkonu).

The authors present their results with the treatment of nephrolithiasis of the lower calix using the method of extracorporeal lithotripsy with the Czech apparatus Medilit M-5. In 310 patients they made 452 operations and checked the therapeutic results three months after the last session. For checking they used a native nephrogram and examination by ultrasound. With the increasing size of concrements the effectiveness declined and thus also the success of ESWL(in concrements above 20 mm in size it declined to 30%). This is not due only to the size of the concrement but also its site in the lower calix which is unfavourable for the elimination of fragments after ESWL. The authors recommend therefore in large concrements of the lower calix (more than 20 mm in the longitudinal axis) to select as the primary method percutaneous nephrolithotomy which is highly effective in this localization and is independent on the size of the concrement. The general success rate achieved in treatment of lithiasis of the lower renal calix with Medilit M-5 is 61.3% and is comparable with other lithotriptors.

[Implantation of inflatable penile prostheses as an effective alternative surgical treatment for erectile disorders]. / Implantace inflatabilní penilní protézy jako efektivní alternativa chirurgického resení poruch erekce.

The authors present an account of their own experience with results and complications of inflatable penile prostheses implanted in a group of 30 patients with organic erectile dysfunction. They discuss possible complications of this operation as well as the place of penile prostheses in the treatment of erectile dysfunction.

[An unusual case of plastic penile induration]. / Neobvyklý prípad induratio penis plastica.

The presence of calcified plaques is one of the few unequivocal indications for surgery of Peyronie's disease. The mean size of plaques described in the literature is 1.5-2 cm whereby it may vary from 1 mm all along the penis. The authors treated successfully an unusually large calcified plaque 7 x 0.8 cm with excellent postoperative results--restoration of the patient's full sexual activity which was not possible before operation.

Business process quality management: a step beyond continuous quality improvement.

Customer demands and financial pressures have forced hospitals to reassess the quality of their services and the efficiency with which they are delivered. A number of institutions have turned to continuous quality improvement methods to help streamline specific processes. For institutions to survive, however, they must look beyond specific processes to broader issues of scope of practice. One hospital's use of Juran's BPQM framework helped position the institution for future economic demands.

A multidisciplinary, multifaceted HIV program: linking the resources.

The current and potential impact of the human immunodeficiency virus (HIV) disease on the financial and human resources of institutions requires strategic planning by health care administrators and providers. The HIV disease devastates the lives of many individuals, and it continues to impact the health care industry with accelerating force. Fairfax Hospital has developed a comprehensive HIV program to address the current needs of people afflicted with this disease and to manage for the future. Goals and strategies are discussed.